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Three Key Takeaways from the FY 2021 Inpatient Prospective Payment System Proposed Rule

Typically, we would have the Final Rule updates to the Inpatient Prospective Payment System (IPPS) for the 2021 fiscal year (FY) 60 days prior to its effective date. However, this year, citing the COVID-19 public health emergency (PHE), publication was delayed. The final rule was published on September 1, or 30 days before the effective date.

Five Key Takeaways from the CY 2021 Outpatient Prospective Payment System Proposed Rule

On August 4, the Centers for Medicare & Medicaid Services (CMS) released the Changes to Hospital Outpatient Prospective Payment System (OPPS) for the 2021 calendar year (CY). The proposed regulations were published in the Federal Register on August 12, and comments are due by October 5.

Get prepared for the 2021 OPPS Proposed Rule and the IPPS Final Rule with two live complimentary webinars in September.

You’re invited to join us in September on Thurs. September 17th, and Thurs. September 24th, for two complimentary live webinars to get up-to-speed on the OPPS Proposed Rule CY2021 and the IPPS Final Rule for FY2021.  Register today to make sure you  will have the information needed to prepare for the coding and regulatory updates.

Panacea Special Edition / Laboratory Services Update During COVID-19 PHE

Panacea’s consultants have been closely monitoring both Centers for Medicare and Medicaid Services (CMS) and American Medical Association (AMA) published guidance for newly created codes for billing during the COVID-19 public health emergency (PHE). Since February 2020, there have been many new codes added for COVID testing and specimen collection.

UPDATE: Billing for Hospital Outpatient Services During the COVID-19 PHE

On July 28, 2020, CMS released a new FAQ for Hospital Billing for Remote Services (Section LL) and expanded the FAQ for Outpatient Therapy Services (Section MM) in the COVID-19 Frequently Asked Questions (FAQs) on Medicare Fee-for-Service (FFS) Billing document[1].

What Radiology Practices Need to Know About Medicare’s Prior-Authorization Requirements

Beginning July 1, Medicare will require prior authorization for five procedure classes: blepharoplasty, botulinum toxin injections, panniculectomy, rhinoplasty, and vein ablation. As a reminder, prior authorization was announced through the Calendar Year 2020 Outpatient Prospective Payment System/Ambulatory Surgical Center Final Rule (CMS-1717-FC).

How to Rationalize Chargemaster Prices

Have you ever wondered how hospital prices became so irrational? As is often the case, things changed incrementally. Hospitals and healthcare systems…

Hospital Zero-Base Pricing® A Novel Approach to Establishing Rational Chargemaster Prices

Can You Document and Defend Your Chargemaster Prices Under the 2020 CMS Final Rule?   

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Are You Reconciling Your Laboratory Orderables to Your Chargemaster? A How-To in 4 Steps

Over the last several months we’ve seen an uptick in requests from clients nationwide for help reconciling laboratory orderables to chargemasters. In case you’re in this same boat, we wanted to provide some insight into the steps you should be taking.

Relaxing Rules for Telehealth

I’m sure everyone has heard the saying“the only constant is change.” Well, it certainly rings true these days. The Centers for Medicare & Medicaid Services (CMS) issued a second interim final rule on April 30, offering another round of coding and documentation updates related to telehealth during the public health emergency.

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